Identificador lógico deste artefato

Metadados sobre o recurso

Conjunto de regras sob as quais este conteúdo foi criado

Idioma do conteúdo do recurso

Resumo do texto do recurso em linguagem natural

Recursos contidos em linha

URL de data e hora de redução

Extensão que não pode ser ignorada

Identificadores externos para este item

O estado clínico da alergia ou intolerância

Afirmação sobre a certeza associada a uma propensão, ou risco potencial, de uma reação à substância identificada

Identificação do mecanismo fisiológico subjacente a um Risco de Reação

Categoria de uma substância identificada associada a alergias ou intolerâncias

Estimativa do dano clínico potencial, ou gravidade, de uma reação a uma substância identificada

Tipo de substância/produto, condição de alergia ou intolerância ou ou código para alergia ausente/desconhecida

Referência do paciente

Identificador exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Referência literal, URL relativa, interna ou absoluta

Tipo ao qual a referência se refere (por exemplo: Paciente)

Referência lógica, quando a referência literal não é conhecida

Texto alternativo para o recurso

Quando a alergia ou intolerância foi afirmada

Quando a alergia ou a intolerância foi identificada

Data em que a primeira versão da instância do recurso foi registrada

Quem registrou a sensibilidade

Fonte da informação sobre a alergia

Data (/hora) da última ocorrência conhecida de uma reação

Texto adicional não capturado em outros campos.

Eventos de reação adversa relacionados à exposição da substância

ID exclusivo para referência entre elementos

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Conteúdo adicional definido por implementações

Substância específica ou produto farmacêutico considerado responsável pelo evento

Código para a manifestação de reação de alergia ou intolerância do subconjunto SNOMED IPS do SNOMED CT (IPS Free Set)

Descrição do evento como um todo

Data (/hora) em que as manifestações apareceram

mild | moderate | severe (of event as a whole)

Como o sujeito foi exposto à substância

Texto sobre evento não capturado em outros campos

Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

Identificador lógico deste artefato

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Metadados sobre o recurso

Conjunto de regras sob as quais este conteúdo foi criado

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Idioma do conteúdo do recurso

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

Resumo do texto do recurso em linguagem natural

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Recursos contidos em linha

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

URL de data e hora de redução

Extensão que não pode ser ignorada

Identificadores externos para este item

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.

O estado clínico da alergia ou intolerância

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

The clinical status of the allergy or intolerance.

Afirmação sobre a certeza associada a uma propensão, ou risco potencial, de uma reação à substância identificada

In the scope of the IPS the entered-in-error concept is not allowed.

Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

Identificação do mecanismo fisiológico subjacente a um Risco de Reação

Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.

Identification of the underlying physiological mechanism for a Reaction Risk.

Categoria de uma substância identificada associada a alergias ou intolerâncias

This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.

Category of an identified substance associated with allergies or intolerances.

Estimativa do dano clínico potencial, ou gravidade, de uma reação a uma substância identificada

The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.

Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

Tipo de substância/produto, condição de alergia ou intolerância ou ou código para alergia ausente/desconhecida

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Type of the substance/product, allergy or intolerance condition or or a code for absent/unknown allergy.

Referência do paciente

Identificador exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Referência literal, URL relativa, interna ou absoluta

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Tipo ao qual a referência se refere (por exemplo: Paciente)

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

Referência lógica, quando a referência literal não é conhecida

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Texto alternativo para o recurso

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Quando a alergia ou intolerância foi afirmada

Quando a alergia ou a intolerância foi identificada

Data em que a primeira versão da instância do recurso foi registrada

Quem registrou a sensibilidade

Fonte da informação sobre a alergia

The recorder takes responsibility for the content, but can reference the source from where they got it.

Data (/hora) da última ocorrência conhecida de uma reação

This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.

Texto adicional não capturado em outros campos.

For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.

Eventos de reação adversa relacionados à exposição da substância

ID exclusivo para referência entre elementos

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Conteúdo adicional definido por implementações

Substância específica ou produto farmacêutico considerado responsável pelo evento

Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.

Codes defining the type of the substance (including pharmaceutical products).

Código para a manifestação de reação de alergia ou intolerância do subconjunto SNOMED IPS do SNOMED CT (IPS Free Set)

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Code for the allergy or intolerance reaction manifestation from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).

Descrição do evento como um todo

Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.

Data (/hora) em que as manifestações apareceram

mild | moderate | severe (of event as a whole)

It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

Como o sujeito foi exposto à substância

Coding of the route of exposure with a terminology should be used wherever possible.

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

Texto sobre evento não capturado em outros campos

Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.

Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

Identificador lógico deste artefato

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Metadados sobre o recurso

Conjunto de regras sob as quais este conteúdo foi criado

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Idioma do conteúdo do recurso

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

Resumo do texto do recurso em linguagem natural

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Recursos contidos em linha

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

An Extension

URL de data e hora de redução

Extensão que não pode ser ignorada

Identificadores externos para este item

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.

O estado clínico da alergia ou intolerância

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

The clinical status of the allergy or intolerance.

Afirmação sobre a certeza associada a uma propensão, ou risco potencial, de uma reação à substância identificada

In the scope of the IPS the entered-in-error concept is not allowed.

Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

Identificação do mecanismo fisiológico subjacente a um Risco de Reação

Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.

Identification of the underlying physiological mechanism for a Reaction Risk.

Categoria de uma substância identificada associada a alergias ou intolerâncias

This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.

Category of an identified substance associated with allergies or intolerances.

Estimativa do dano clínico potencial, ou gravidade, de uma reação a uma substância identificada

The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.

Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

Tipo de substância/produto, condição de alergia ou intolerância ou ou código para alergia ausente/desconhecida

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Type of the substance/product, allergy or intolerance condition or or a code for absent/unknown allergy.

Referência do paciente

Identificador exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Referência literal, URL relativa, interna ou absoluta

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Tipo ao qual a referência se refere (por exemplo: Paciente)

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

Referência lógica, quando a referência literal não é conhecida

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Texto alternativo para o recurso

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Quando a alergia ou intolerância foi afirmada

Quando a alergia ou a intolerância foi identificada

Data em que a primeira versão da instância do recurso foi registrada

Quem registrou a sensibilidade

Fonte da informação sobre a alergia

The recorder takes responsibility for the content, but can reference the source from where they got it.

Data (/hora) da última ocorrência conhecida de uma reação

This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.

Texto adicional não capturado em outros campos.

For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.

Eventos de reação adversa relacionados à exposição da substância

ID exclusivo para referência entre elementos

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Conteúdo adicional definido por implementações

Substância específica ou produto farmacêutico considerado responsável pelo evento

Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.

Codes defining the type of the substance (including pharmaceutical products).

Código para a manifestação de reação de alergia ou intolerância do subconjunto SNOMED IPS do SNOMED CT (IPS Free Set)

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Code for the allergy or intolerance reaction manifestation from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).

Descrição do evento como um todo

Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.

Data (/hora) em que as manifestações apareceram

mild | moderate | severe (of event as a whole)

It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

Como o sujeito foi exposto à substância

Coding of the route of exposure with a terminology should be used wherever possible.

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

Texto sobre evento não capturado em outros campos

Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.